Heart Healthy for Life

What every woman needs to know to protect her heart

By Stacey Colino

When it comes to women and heart disease, we've made tremendous strides: More women know that it's a top health threat, but the message doesn't always translate into action. "Women know about heart disease, but often don't consider how it relates to them personally and what they need to do to prevent it," says Nieca Goldberg, M.D., medical director of the New York University Women's Heart Program and author of Dr. Nieca Goldberg's Complete Guide to Women's Health (Ballantine).

Indeed, surveys have found that only 21 percent of women think they might be at risk, which partly explains why more of us aren't adopting heart-healthy habits. But Woman's Day is here to change that: Experts agree—and research shows—that heart disease is largely preventable if you lead a healthy lifestyle. In fact, a new study from the Karolinska Institute in Stockholm found that women who eat a balanced diet, drink a moderate amount of alcohol, stay physically active, maintain a healthy weight and don't smoke can reduce their risk of having a heart attack by 77 percent. "We're learning that lifestyle has more of an impact on our hearts than we ever thought," says Lori Mosca, M.D., director of preventive cardiology at New York Presbyterian Hospital. Armed with our guide—complete with heart-friendly foods and an easy exercise plan—get ready to lower your risk of heart disease, starting today.

The overlooked risk factors

We all know the usual suspects (high cholesterol, high blood pressure, diabetes) that increase your chances for cardiovascular and heart disease. But experts say that women—and often primary-care physicians—aren't paying as much attention to the following risk factors as they should. Plus emerging research is showing that there may also be a link between heart disease and other conditions including sleep apnea and depression. If any of these sound familiar, be sure to discuss them with your doctor, as she may want to monitor you more closely for heart disease.

Family history

Yes, it matters—a lot. But recent research reveals that 60 percent of women whose mothers, fathers, sisters, brothers, aunts or uncles have had heart attacks don't think they're at increased risk for having one themselves. And it's not enough just to know whether any relatives had a heart attack or died of heart disease, Dr. Mosca says. You also need to find out if anyone has had angina, bypass surgery, angioplasty, an aortic abdominal aneurysm, stroke or peripheral artery disease (PAD), because a family history of these conditions also raises your risk of developing cardiovascular disease.

Being overweight

You don't have to be obese to up your risk: A recent study from the Netherlands suggests that being overweight (having a body mass index between 25 and 29.9) increases your chance of developing heart disease by 32 percent. "People need to be more aggressive about dealing with weight, because it's a risk factor for cardiovascular disease and diabetes, which is directly linked to heart disease," says Dr. Goldberg.

Emotional well-being

"People who are depressed have a two- to five-fold increased risk of cardiovascular disease," says Sharonne Hayes, M.D., director of the women's heart clinic at the Mayo Clinic in Rochester, Minnesota. The reason for the link is not totally understood, but we do know that people who are depressed have higher levels of inflammation and stress hormones and a greater risk of high blood pressure, arrhythmias and blood clots, says Dr. Hayes.

Oral health

Keeping your teeth and gums healthy (brushing and flossing daily and seeing a dentist regularly) may reduce your risk of some heart infections such as bacterial endocarditis. Plus, recent stats show that women with gum disease have twice the risk of having a heart attack of those who don't.

Casual smoking

"Young women who smoke socially—five to 10 cigarettes a weekend—may not think anything of it, but even this amount can erase the natural protection of estrogen," says Dr. Hayes. Even being around a smoker can do damage: One study suggests that women who live with a smoker have up to a 35 percent increased risk of developing cardiovascular disease as they get older.

Obstructive sleep apnea

Experts think this condition, which causes loud snoring and brief pauses in breathing during sleep, may contribute to heart disease, and it's hugely underrecognized in women, says Dr. Hayes. "People with sleep apnea have higher rates of atrial fibrillation, an abnormal beating rhythm, and heart failure." If you often wake up with a headache, feel tired despite getting six hours plus of shut-eye, or feel really sleepy and lethargic during the day for a few weeks, talk to your doctor about getting screened for OSA.

Pregnancy-related issues

If you had preeclampsia (a potentially life-threatening condition that causes high blood pressure), your chances of developing heart disease in your 50s increases twofold, says Dr. Goldberg. Having gestational diabetes ups your risk of being diagnosed with type 2 diabetes in the 10 years post-pregnancy, which in turn raises your heart disease risk.

Peripheral artery disease

Never heard of it? Neither have 75 percent of people over 50, says a recent large survey, but about 8 million people have it. There's a strong association between PAD, a disease in which the arteries in the legs narrow or get clogged, and heart disease. "The mechanism is the same—the buildup of plaque and clotting causes blockages in the heart, neck, head and legs," Dr. Mosca explains. If you have symptoms, including an aching, burning pain in your legs, tell your doctor pronto, especially if you have high blood pressure, high cholesterol or diabetes. (It mostly affects people 50 and over, but anyone can get it.) PAD can be diagnosed with a test called the ankle-brachial index, which compares the blood pressure in your ankle with the blood pressure in your arm.

Take control and see the payoff

Walking briskly for three to five hours a week can cut your risk of heart disease by as much as 35 percent.

Lower your cholesterol, and your heart disease risk goes down within six months. If it stays healthy, your risk can drop up to 75 percent within two years.

Lower your blood pressure and you’ll lower your chances of having a heart attack and stroke by 20 to 50 percent.

Control your blood sugar if you have diabetes, and you may slash your heart disease risk by 20 percent or more.

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